Abstract
Osteoprotegerin (OPG), receptor activator of the nuclear factor κB ligand (RANKL) and fibroblast growth factor-23 (FGF-23) play a central role in renal osteodystrophy. We evaluated OPG/RANKL and FGF-23 levels in 51 children with chronic kidney disease (CKD) [n = 26 stage 3 or 4 (CKD3–4) and n = 25 stage 5 (CKD5)] and 61 controls. Any possible association with intact parathyroid hormone (iPTH) and bone turnover markers was also investigated. The OPG levels were lower in the CKD3–4 group (p < 0.001) and higher in the CKD5 group (p < 0.01) than in the controls, while RANKL levels did not differ. The FGF-23 levels were higher in both patient groups (p < 0.0001), while the levels of phosphate and iPTH were higher only in the CKD5 group (p < 0.0001). There were independent positive correlations between OPG and RANKL (β = 0.297, p < 0.01) and FGF-23 (β = 0.352, p < 0.05) and a negative correlation with the bone resorption marker TRAP5b (β = −0.519, p < 0.001). OPG was positively correlated with iPTH (R = 0.391, p < 0.01). An independent positive correlation between FGF-23 and phosphate (β = 0.368, p < 0.05) or iPTH (β = 0.812, p < 0.0001) was noted. In conclusion, we found that higher OPG levels in patients with CKD stage 5 correlated with the levels of RANKL, FGF-23, iPTH, and TRAP5b. These findings may reflect a compensatory mechanism to the negative balance of bone turnover. High FGF-23 levels in early CKD stages may indicate the need for intervention to manage serum phosphate (Pi) levels.
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Abbreviations
- BAP:
-
bone alkaline phosphatase
- Ca:
-
calcium
- CKD:
-
chronic kidney disease
- CICP:
-
C-terminal propeptide of type I collagen
- CrossLaps:
-
C-terminal telopeptides of type I collagen
- 1,25(OH)2D:
-
1,25-dihydroxyvitamin D
- FGF-23:
-
fibroblast growth factor-23
- GFR:
-
glomerular filtration rate
- HD:
-
hemodialysis
- 25OHD:
-
25-hydroxyvitamin D
- iPTH:
-
intact PTH
- N-MID OC:
-
N-terminal-MID osteocalcin
- OPG:
-
osteoprotegerin
- PD:
-
peritoneal dialysis
- Pi:
-
phosphate
- PTH:
-
parathyroid hormone
- RANKL:
-
receptor activator of the nuclear factor κB ligand
- RO:
-
renal osteodystrophy
- sCre:
-
serum creatinine
- TRAP5b:
-
tartrate-resistant acid phosphatase isoform 5b
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Siomou, E., Challa, A., Printza, N. et al. Serum osteoprotegerin, RANKL and fibroblast growth factor-23 in children with chronic kidney disease. Pediatr Nephrol 26, 1105–1114 (2011). https://doi.org/10.1007/s00467-011-1870-5
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DOI: https://doi.org/10.1007/s00467-011-1870-5